Poisonous cultures

I have already written about workplace cultures and how they can lead to poor standards. These cultures are usually not management led, and management may not know. However if a culture is there for all to see, there is no excuse except cowardice (is that an excuse?) for not dealing with it.

I have elderly relatives, and sometimes they get sick or have accidents and end up in hospital. It depends which hospital they get taken to as to whether they are in good conditions or much worse conditions.

I am not going to rant about the British National Health Service, which is state funded from taxes and is mostly pretty good. I am mentioning this in case you are my reader in Madagascar and did not know this background. The point of this piece is going to be that you can have exactly the same resources and end up with a different result.

One relative ended up in a geriatric ward where summoning a member of staff by ringing a bell was almost futile. It was possible someone might turn up in fifteen minutes, which was rather too long for a senior person needing a bedpan or to be taken to the lavatory. The consequence of this delay was bound to be unfortunate.

My relation was left sitting in a chair in her hospital ward without her glasses, so she could not see what was going on, or read or do anything. She was left without her teeth so certainly couldn’t eat properly. The other patients seemed similarly abandoned.

Was this all due to staff shortages? There were plenty of nursing staff and support people hanging around near the desk when I visited, including the times when I went out to request a bedpan for my dear old lady. It still took another ten minutes for anyone to come. We have to conclude it was either staff indifference or “not my job”. Either way there seemed no excuse.

So, at another hospital thirty miles away as the crow flies, another older lady is in hospital after a fall. She is in a bright ward with cheerful attentive staff. She is very happy and says several times what good treatment she is having. She is asked if she is comfortable, whether she can reach her book, and whether she would like her individual TV on.

This elderly lady asks if she can go to the lavatory where she is taken instantly. The nurse asks her if she would like a wash while in the bathroom, and not only runs the water, but helps the lady to wash her back and other bits hard to reach. Yet here the staff are more bustling around. They seem more busy, but that is because they are doing their job, which is caring for people.

I don’t doubt that the clinical care in both hospitals is good. The support care is plainly very good in one hospital and downright poor in the other.

In such a situation the management on the failing hospital could not fail to be aware of the situation. It would be a simple question of observation when they turned up for an unscheduled or even scheduled visit to each ward. The only explanation is that they go along with the culture. They don’t want to make waves. They don’t want to upset the staff by suggesting they do better. The patients suffer when they are supposed to be getting well.

Imagine what would happen in a business like this. Of course it would fail. No management team could let this sort of culture go on, because it would cost them their jobs. The only reason such a situation could prevail in a hospital is because it is tax-funded. As long as they meet their budget there is no incentive to be better if the management and staff lack such compassion for their patients or any moral sense of responsibility.

I have seen businesses fail through lack of responsibility to the customers and ultimately it is through lack of responsibility for each other. We need to work together for the common good and not just go along with what we might get away with. How do you feel about this?